Active NPI
Jacqueline Russo Strait, LCSW
- Clinical Social Worker
- Philadelphia, PA
National Provider Identifier
1184900441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CW016367
- Practice address
- 255 S 17TH St
Suite 1307
Philadelphia, PA 19103-6231 - Phone
- (267) 908-5292
- NPI assigned
- Oct 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CW016367 | PA | Primary |
Addresses
Primary practice location
255 S 17TH St
Suite 1307
Philadelphia, PA 19103-6231
Mailing address
255 S 17TH St
Suite 1307
Philadelphia, PA 19103-6231
Phone (267) 908-5292
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CW016367 | PA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1320019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1355184000000",
"number": "1184900441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 S 17TH ST",
"address_2": "SUITE 1307",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191036231",
"telephone_number": "267-908-5292"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 S 17TH ST",
"address_2": "SUITE 1307",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191036231",
"telephone_number": "267-908-5292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRAIT",
"first_name": "JACQUELINE",
"middle_name": "RUSSO",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-31",
"last_updated": "2012-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PA",
"license": "CW016367",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.